K0902 – Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf

Long description

Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf

Short description

Ko double upright pre ots

Pricing indicator

38 Orthotics, prosthetics, prosthetic devices & vision services

Medicare coverage

C Carrier judgment – coverage decided by the Medicare contractor

BETOS category

D1F Prosthetic/Orthotic devices

Cross reference

L1852

Added

October 1, 2014

Last change

January 1, 2017 – No change

Termination date

December 31, 2016

Nearby K codes

• K0885 – Power wheelchair, group 4 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds
• K0886 – Power wheelchair, group 4 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds
• K0890 – Power wheelchair, group 5 pediatric, single power option, sling/solid seat/back, patient weight capacity up to and including 125 pounds
• K0891 – Power wheelchair, group 5 pediatric, multiple power option, sling/solid seat/back, patient weight capacity up to and including 125 pounds
• K0898 – Power wheelchair, not otherwise classified
• K0899 – Power mobility device, not coded by dme pdac or does not meet criteria
• K0900 – Customized durable medical equipment, other than wheelchair
• K0901 – Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf
• K0903 – For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each
• K1001 – Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type
• K1002 – Cranial electrotherapy stimulation (ces) system, any type
• K1003 – Whirlpool tub, walk-in, portable
• K1004 – Low frequency ultrasonic diathermy treatment device for home use
• K1005 – Disposable collection and storage bag for breast milk, any size, any type, each
• K1006 – Suction pump, home model, portable or stationary, electric, any type, for use with external urine management system
• K1007 – Bilateral hip, knee, ankle, foot device, powered, includes pelvic component, single or double upright(s), knee joints any type, with or without ankle joints any type, includes all components and accessories, motors, microprocessors, sensors